Erythermalgia. Review of 51 Cases.

ALTHOUGH case reports of painful, red extremities date back at least to 1834,1 Mitchell first analyzed the symptoms in 1878 and suggested the term "erythromelalgia."2 During the ensuing 55 years, reparts of this entity appeared so sporadically that, in 1933, Lewis 3 considered that the term lacked precise definition and should be abandoned. In 1938, however, Smith and Allen4 reported a series of patients who had elevated local skin temperatures besides the characteristic burning distress and red discoloration. They termed the condition "erythermalgia" and stated: "This condition is characterized by burning distress, involving any of the extremities, which is inseparably linked with, and entirely dependent on, elevation of the temperature of the skin of the affected parts." They further pointed out that the condition could be either primary (idiopathic) or secondary (related to nervous, peripheral vascular, or other diseases). Since then, only sporadic mention of this syndrome has been found in the literature.A8 Our impression that significant clinical differences may exist between the primary and the secondary form and our experience of finding erythermalgia as an important clue to more serious disease prompted this review. Fifty-one cases of this syndrome, seen at the Mayo Clinic during the years 1951 to 1960 inclusive, were considered sufficiently informative to be included in this report. Table 1